Picky Eating, Sensory Struggles & the Microbiome: A Whole-Child Approach with Dr. Elisa Song

What if you can help your child become a more adventurous eater without changing their diet first? 

In this episode of The Livin’Sky Podcast, I sit down with integrative pediatrician Dr. Elisa Song, the bestselling author of Healthy Kids Happy Kids, An Integrative Pediatrician’s Guide to Whole Child Resilience, to explore what’s really behind picky eating, sensory struggles, and rising health challenges in kids today — and how we can help them heal from the inside out.

From the vagus nerve to the gut-brain axis, Dr. Song shares practical ways to support your child’s microbiome and nervous system without pressure or perfection. Whether your child eats five foods or fifty, this conversation offers empowering, low-stress tools that work.

Takeaways

• The vagus nerve can shift your child’s microbiome — even without changing diet.

Dr. Song explains how stimulating the vagus nerve helps improve gut diversity and resilience, which can reduce picky eating and sensory overwhelm.

• Gut health influences food cravings, behavior, and mood.

The microbiome isn’t just about digestion — it plays a major role in your child’s emotional regulation and food preferences, including selective eating.

• Zinc deficiency is a major but overlooked root cause of sensory struggles and picky eating.

From taste aversions to sensitivity to sounds, tags, or textures — zinc is often the missing piece.

• Behavioral feeding therapy isn’t enough if we don’t address internal imbalances.

Many feeding therapies focus only on increasing bites or exposure — but without calming the nervous system and healing the gut, progress often stalls.

• Sensory sensitivities are often a sign that the body doesn’t feel safe.

Kids who are overwhelmed by textures, flavors, and smells need more nervous system support before they can feel safe enough to try new foods.

• Microbiome healing can start with simple, doable changes.

Sleep, hydration, breathwork, movement, and emotional connection all help shift the gut — no food battles required.

• Connection and co-regulation are therapeutic.

Working on nervous system safety together — even outside of mealtime — builds trust, reduces stress, and lays the foundation for better eating.

• Pre-diabetes is on the rise in kids — even in those who look "healthy."

Many children are showing early signs of metabolic dysfunction due to hidden sugars in “healthy” foods. Awareness and label-reading are key.

Resources

• Dr. Elisa Song’s book: Healthy Kids, Happy Kids
• More resources at www.healthykidshappykids.com

Grab your Bon Charge gear here, code LenaL for 15% off your purchase 

Grab your SIGNALS shake at 10% off with code Lena10

Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider before making significant dietary changes.

Transcript

Lena Livinsky (00:00)
Dr. Elisa Song is a Stanford, NYU, and UCSF trained integrative pediatrician, functional medicine expert, and mom of two kids who's revolutionizing children's health. Her bestselling book, Healthy Kids, Happy Kids, an Integrative Pediatrician's Guide to Whole Child Resilience is my absolute go-to whenever anyone in my family gets sick.

Through her practice and website, healthykidshappykids.com, she's helped thousands of children get to the root causes of their health concerns by brilliantly blending conventional pediatrics with functional medicine approaches. As someone who's been personally mentored by Dr. Song over the past year, I've witnessed firsthand her incredible gift for making complex health information accessible and actionable for both parents and practitioners. Dr. Song is truly bridging the gap between conventional and integrative pediatrics with her

evidence-based, pediatrician-backed, mom-approved approach. Dr. Song, I'm beyond honored to welcome you to the Livin'Sky podcast today. Thank you for being here.

Dr. Elisa Song (00:55)
thanks. It's an honor for me to be here, Lena.

Lena Livinsky (00:57)
Thank you. So I want to know how you got started. What experiences guided your choices to pursue integrative health?

Dr. Elisa Song (01:04)
You know, my story, I think, is a little different than many practitioners who have found functional medicine or holistic health, because many practitioners who started in the conventional world, it's really through some sort of a health crisis or health problem that they or their family members experienced. And conventional medicine didn't really have all the answers. For me, it was more I just, you know, even in high school was so interested in different forms of healing and and spirituality. And so when I went to

Lena Livinsky (01:20)
Mm-hmm.

Dr. Elisa Song (01:32)
college, it was just by pure luck that I stumbled upon this flyer for what was back, this was back in the 1980s, the American Holistic Medical Association. you know, instantly, I was like, what is holistic medicine? And so as a junior in college, I drove myself down to the Santa Clara Convention Center. And really, my mind was blown. I heard from

Lena Livinsky (01:47)
Mm-hmm.

Dr. Elisa Song (01:57)
folks who are just starting to get known like Andrew Weil and Deepak Chopra and Joan Borisenko. And I remember coming home to my dorm, not even at that point wanting to be a pediatrician. I was going to be a civil rights, you know, children's rights lawyer. And I was a public policy political science major. But then I thought, well, maybe I could do this. So I remember calling my mom at that point and saying, Hey, mom, you know what, I think that I might want to be a naturopathic doctor.

Lena Livinsky (02:12)
Wow, very different.

Dr. Elisa Song (02:24)
And she was like, what's that? I mean, no one ever discouraged me. But also back then, no one really in my circle knew what that was. So I was never really completely encouraged. And a lot of people said, well, why don't you just, you why don't you go to regular medical school? You can always do that later. So anyhow, that was my path. I decided to pivot from law into medicine. And really that desire has informed what

education I pursued and even the practice that I first opened up straight out of residency, you know, starting from medical school.

Lena Livinsky (02:58)
Wow, that's quite a story. And I feel like holistic health in general, it wasn't really embraced until just a few years ago, feels like maybe like 10, 15 years, it took a while.

Dr. Elisa Song (03:06)
It's I mean, yeah,

it's growing. But if you think about it, I mean, that was like almost 40 years ago, right? Isn't that crazy? ⁓ it was actually called I remember the ⁓ NIH had an office of complementary and alternative medicine, right? It wasn't called holistic, it wasn't called integrative. And, and now I'm really shifting more towards calling it integrative medicine, because really acknowledging that conventional pediatrics

Lena Livinsky (03:12)
Yeah. Yeah.

Mm-hmm.

Mm-hmm.

Dr. Elisa Song (03:33)
has a role in helping our children and us as adults. But also we now know that a lot of conventional medicine is geared more towards symptoms and not understanding root causes and frankly can have many effects, especially in kids, the use and I would say overuse and misuse of antibiotics with long-term implications on their gut microbiomes and

Lena Livinsky (03:45)
Yes.

Dr. Elisa Song (04:01)
Their gut brain connections and gut immune system connections. So as we start to understand this, we can take what we need from conventional pediatrics, but also know we have to incorporate and integrate other modalities that are not alternative, but really a part of keeping our kids well, including functional medicine, nutrition, herbs, acupressure, essential oils, all the things.

Lena Livinsky (04:26)
Absolutely. So what happens to the body when a child takes antibiotics? Why can it be so harmful? Even though it can save lives, there's definitely a space for it, but it's so widely overused, like you mentioned.

Dr. Elisa Song (04:36)
I have to remind myself that a lot of parents don't realize, first of all, how overused and misused antibiotics are. As you said, they can absolutely be life-saving. And in fact, even as an integrated pediatrician, I rarely need to write antibiotic prescriptions. But when I do, I know that they're absolutely necessary, which is what I want for all parents.

⁓ But, know, for instance, my son, he got this horrible, I mean, this really bad gouge, you know, from the bottom of a swimming pool two weeks ago. And so last week he came to me and said, mama, my foot's hurting. And I looked at it and I mean, there was a big, you know, round pustule and red streaking up his foot. And it was hot and tender and swollen. And I told my husband, like, we can't mess with cellulitis. I mean, this is one case where I know

Lena Livinsky (05:05)
Mm.

Dr. Elisa Song (05:25)
antibiotics are definitely indicated. So I started them up on antibiotics. But what's the problem there, right? Because antibiotics kill all the bad bugs, but they're not specific. They can kill all of the beneficial bacteria that are in your gut microbiome. And frankly, in all of our microbiomes, we actually have multiple microbiomes. Our skin has a microbiome. Our gut microbiome is most well understood. But women also have a vaginal microbiome that's really important, you know, in terms of

vaginal health and risk for things like chronic UTIs or vaginitis, HPV, even for pregnancy outcomes and PCOS. so understanding that antibiotics can wipe out even the good bacteria, we want to enter into antibiotics with that knowledge and then make sure we're doing everything we can to restore the gut microbiome

Lena Livinsky (06:05)
Mm-hmm.

Dr. Elisa Song (06:21)
⁓ during and after antibiotics.

Lena Livinsky (06:23)
absolutely. And you're the perfect person to learn about that from. The microbiome queen, as I think people call you. So can you tell us a little bit about that? What can we do to restore our microbiome?

Dr. Elisa Song (06:30)
Hahaha.

Yeah, so, you know, in my book, I go through a whole gut reset plan, which, you know, is really for kids who either have been on antibiotics or, you know, have any sort of a chronic health concern. It's a little abbreviated with antibiotics. But one of the things that's really important that I want all parents and kids to understand is it's not just about taking a probiotic supplement. There's way more than that, right?

because probiotic supplements are only going to be able to restore your gut microbiome if your gut microbiome is in a healthy state. Now, many people talk about the gut microbiome as all of the bugs in your gut, the composition of bacteria and viruses and yeast and maybe even some parasites, but the microbiome is actually an ecosystem. And the organisms that are there is your microbiota.

Lena Livinsky (07:15)
Mm-hmm.

Dr. Elisa Song (07:25)
Right? And so when we think about this ecosystem in your gut, you know, I have kids think about, you know, growing a garden, right? And if you think about, you know, your beautiful tomato plants and your cilantro and peppers or whatever you're growing as your good probiotics, what do we need that ecosystem in the soil to look like? We need it to be nourished, you know, with the right ingredients to feed the growing plants. So same thing with your gut microbiome. We need your gut microbiome to be nourished.

Lena Livinsky (07:25)
Mm-hmm.

Dr. Elisa Song (07:51)
in the most appropriate way to feed the appropriate probiotic species that you want back in your gut. So that means eating in a way that's healthful, getting enough sleep, hydrating, getting enough stress relief to optimize your vagus nerve. So that's the foundation. And then when it comes to antibiotics, yes, you also, I think, do need some supplements just as a safeguard. probiotic supplements have a role.

Prebiotic supplements that can help feed the good bacteria can also play a role if your child went into the antibiotics already with some sort of a health concern Chances are they have a little what's called leaky gut so then antibiotics can worsen that so then you may also want to consider giving leaky gut supplements like Glutamine and zinc and fish oils and quercetin so at the foundation though

would be cleaning up the diet and lifestyle, getting in a probiotic supplement and getting in a prebiotic supplement for at least a month or two after the antibiotics are completed, but starting even while you're taking antibiotics. The only thing with timing is that the probiotic supplements need to be taken at least an hour or two away from your antibiotic dose because the antibiotics might just

Lena Livinsky (09:11)
Okay.

Dr. Elisa Song (09:14)
immediately go and kill the probiotics.

Lena Livinsky (09:17)
that makes a lot of sense. So is there anything else that can be a gut disruptor outside from antibiotics? Is there anything in an environment that can also cause the leaky gut?

Dr. Elisa Song (09:27)
Yeah, we have, unfortunately, our world is kind of filled with microbiome disruptors. And that is why, you know, how we live and eat on the whole is really what's most important because we can't get rid of all microbiome disruptors. They're just everywhere. We can certainly minimize them. But other microbiome disruptors that our kids and we as adults are confronted with include environmental toxins like Forever Chemicals,

carabines, phthalates, heavy metals, we can lower our burden, but if we're going to live in this modern world, we're all going to be exposed on some level. Glyphosate, which is the pesticide found in non-organic fruits and vegetables, and unfortunately, even some organic ones, but glyphosate or Roundup can kill beneficial bacteria even more preferentially than abnormal bacteria.

And so, you know, it initially was patented actually as an antibiotic. So ⁓ parents need to be aware of that. Other factors can include ultra processed foods. artificial sugars, food additives, this category of food additives called emulsifiers that help to keep our barbecue sauces and our ketchup and salad dressings and ice cream and protein bars together. They should be out, you know, of our packaged foods.

And then even, there's some evidence that EMFs, electromagnetic frequencies can disrupt our microbiome. so, supporting reducing our wifi exposures and then even psychological stress. So it's not ⁓ a reality to eliminate all psychological stress, nor is that desired because we need some stress to function optimally, right? Stress is not.

Lena Livinsky (10:58)
Mm-hmm.

Dr. Elisa Song (11:09)
a quote bad thing. It's just when it's too much and too chronic. And so we need tools to optimize and manage our chronic stress because stress has been shown to trigger leaky gut and disrupt our gut microbiome even within one hour. Yeah. Yep.

Lena Livinsky (11:18)
Mm-hmm.

Wow, that soon. My gosh.

Okay, so what are some things, because I know you have a whole chapter in the book about the vagus nerve. What are some tools that we can use to help our kids with their stress levels?

Dr. Elisa Song (11:37)
Yeah, so, you know, this is one thing that is really important because, for us as even for us as parents, we don't a lot of us don't have great tools to manage stress, to work through stress and come out even stronger and more resilient. I mean, that is the the goal for most of us. Our main tool is avoidance. Right. I mean, just.

Lena Livinsky (12:00)
That's very

true.

Dr. Elisa Song (12:01)
ignoring

it, pretending like it's not there, or just saying, it's going to be okay, and then not dealing with it, right? That actually can build up and up and up and is one of our most maladaptive tools. And so, you know, throughout the day, we're constantly put, you know, if we think about it, constantly put into moments of, you know, fight or flight, even if it's brief.

Right. We're rushing to get our kids to school on time. We have a work deadline or our kids have, you know, a soccer tournament or performance, you know, all these little things that kind of, you know, put us into this stress state, which again, can be really adaptive and helpful because when we have a little bit of stress, it helps us perform. Right. I mean, if we had no stress and no, you know, responsibilities, we probably wouldn't get much done.

Lena Livinsky (12:37)
Yeah.

Dr. Elisa Song (12:51)
And also that can lead to apathy, indifference, depression. The problem is we've swung the other way with too much, like too many responsibilities, too many things to do. And that leads to anxiety and burnout and anger and irritability, right? But there's a sweet spot where there's just like Goldilocks, just the right amount of stress where we are performing optimally. Now, when we're in that fight or flight moment, we need tools to get us out.

Lena Livinsky (13:05)
Yes.

Dr. Elisa Song (13:15)
And so that is what I want kids and adults to practice throughout the day. And in the chapter called Breathe, which is all about engaging your vagus nerve, ⁓ there's several tools, but the easiest and most important tool, I think, is to learn how to breathe with our belly. Because when we breathe with our belly mindfully, when we're in that kind of amped up, heart rate beating, pupils dilated, we feel like something terrible is gonna happen.

Lena Livinsky (13:31)
Mm-hmm.

Dr. Elisa Song (13:42)
or the proverbial saber-toothed tiger is in front of us. If we can slow our breathing down and breathe with our diaphragm, that immediately engages our vagus nerve, slows things down so that then we can be more calm and focused and alert and respond in an appropriate and healthy way. So what does that look like? And I'll do this in the office with kids and parents.

sitting there because it's amazing how many of us have forgotten really how to breathe with our diaphragm. You when you look at a little baby, their belly's going in and out slowly, right? And they're not sucking in their gut, you know, trying to hold it all in, right? And so we want to go back to that time where our shoulders are really relaxed, not using our shoulders to breathe. You know, we're sitting upright, not kind of slumped over, right? And that tech posture that that many of us have. And, and then we imagine

Lena Livinsky (14:19)
Yes.

Mm-hmm.

Dr. Elisa Song (14:35)
that there's a balloon in our belly that inflates and deflates with our breath in and our breath out. And then I'll have parents hold, put one hand on their chest, one hand on their belly. And as you take a slow breath in, your hand on your chest stays still and...

The hand on your belly rises and you hold and then you do exhale.

the hand on your belly completely deflates and the hand on your chest still stays still. And we just, if you do that five times, 10 times, you immediately get put into a calmer state. Like I said, your vagus nerve immediately kicks in. And the beauty of kicking in our vagus nerve is that when we optimize our vagus nerve, that improves your gut microbiome diversity and function independent of diet.

Lena Livinsky (14:59)
Hmm.

Dr. Elisa Song (15:23)
Now that is huge, right? Because we have many, many of us have kids who are picky, who are selective. And we're thinking, my gosh, well, I would love to change your diet and get in, know, 25 grams of fiber and a array of fruits and vegetables and whole grains. But they're kind of stuck on eating a few, you know, handful of foods, right? So I don't want this to be stressful for families if you just then work on the vagus nerve.

You can slowly work on the diet in the background, but working on your vagus nerve will help to shift your child's microbiome and shifting your child's microbiome actually can start to shift their taste preferences and their willingness to explore new foods, which is fascinating because the bugs in our gut can actually start communicate with our brain and tell us what foods to crave. So whatever way you start working on it,

Lena Livinsky (16:11)
Mm-hmm.

Dr. Elisa Song (16:17)
If diet is easy, great. If not, work on breathing and the vagus nerve. Or there's five things in my book, five things for microbiome magic that I put in a wheel. And so you can work on any of those other things, whether it's hydration or sleep or movement. So whichever one is going to be the lowest hanging fruit is what I like to work on first. Because I want kids and I want parents to feel

successful, they're accomplishing something, start to feel better, and then slowly you can add on the other things.

Lena Livinsky (16:49)
I agree completely. And I think with the picky eating too, it's so important to work on that connection piece. And this is exactly what this facilitates as well, working together and calming our nervous system down and connecting together and just taking a step back. But at the same time, these tools are working on optimizing your microbiome, which is incredible already. Because I do think a lot of the therapies out there, which are very well-meaning, they do focus on behavior and they do focus on

perhaps just extending the food list and bites that you take, which is important. Of course, we want our kids eating and nourishing themselves, but sometimes that's just impossible to start with. And I love this like lower hanging fruit that you mentioned. I think it's so important.

Dr. Elisa Song (17:31)
And it also

can be like if your kids really are picky or maybe they have sensory issues that are in the way of them, you know, even wanting to try different foods, like different flavors and textures and smells just don't feel safe to them in the moment. So what we need to do is increase their ability to feel safety. And that's all about the vagus nerve. So if you start with that, not related to food, but just related to let's feel safe in our body.

Lena Livinsky (17:41)
Mm-hmm.

Yes.

Mm-hmm.

Dr. Elisa Song (18:00)
Let's

slow things down. Then that is something that then eventually can translate into, okay, now we know what it feels like to feel safe. Let's remember that feeling as we're even thinking about trying a new food, right? Or even thinking about putting a new food on your plate, even if you don't try it, right? I mean, just little steps, right?

Lena Livinsky (18:21)
Exactly.

And sometimes you can even take it back to the grocery store or the farm or the garden, right, without even the pressure of having it on a table. Yeah, that's such great advice. I know there's some nutritional deficiencies that are associated with picky eating. Could you mention those as well?

Dr. Elisa Song (18:25)
That's Yep.

Yeah,

well, the number one is zinc, right? Zinc is sort of the pearl that I've learned over the years and have shared with parents that oftentimes when you are deficient or insufficient in the mineral zinc, it can contribute to so many sensory issues, including having food taste different. So then you develop taste aversions and picky eating, but also other sensory issues. If you have kids who, you

Lena Livinsky (18:38)
Mm-hmm.

Dr. Elisa Song (19:03)
You never get tags on shirts because they can't stand the tags or you only buy seamless socks. Or maybe they only wear one or two pairs of the same kind of sweatpants or leggings, right? Never wear jeans, right? Or you can't bring them to a public toilet. I mean, they cover their ears. You have to wait to do the vacuum or run the blender when they're out of the house. I mean, those are all sensory issues that are screaming to me, Zinc.

And so, we want to focus on zinc rich foods like animal proteins, pumpkin seeds, beans. But then, of course, if you're picky eaters, that's going to be hard. So one of the things that you can do is just try a zinc supplement at low levels. Ideally, what I do in my office is I will actually do a blood test to measure something called a red blood cell zinc, because I want to be a little more guided in how much I give kids

mostly because some kids, I'm shocked at how much they need to normalize their zinc levels. But if you started with, zinc supplement for your child, that can actually improve taste preferences, their auditory sensitivities. And I just remember this one mom who

she had heard me on a podcast or maybe it was one of my social media posts. so everything I was checking off, know, gets sick frequently, you know, has eczema, ⁓ picky eater, not growing as well as you'd like, auditory sensor, all the things. She's like, my gosh, that's my daughter. Right? So she started a zinc supplement, just got a liquid over-the-counter zinc supplement. And she told me with, and she was eating maybe like

you know, three different foods. So she told me that within a month of starting, her daughter had already tried and accepted and liked five new foods. I mean, that is huge. mean, you know, if you're I mean, as if you are a mom of a picky eater, you know, that's like, ⁓ my gosh, five, like, that's my dream in a year, right. And so it can be I mean, there aren't many things in life that are are, you know, that

Lena Livinsky (20:53)
That is huge.

Yes.

Dr. Elisa Song (21:09)
really that are that profound when it comes to, shifting supplements that can make that quick of a difference. But zinc is one of them that can.

Lena Livinsky (21:17)
Wow, yeah, and I think it's one of the main nutritional deficiencies in children in general that I've heard you and read in the book, right? Because it's so hard for a lot of them to come by, I mean, it is present in many different foods, but if you're a picky eater, then that list gets really low. ⁓ But I've also heard you talk about pumpkin seed powder and how one mom added it to smoothies and it really made a difference, right?

Dr. Elisa Song (21:33)
Yeah, that's right. Yeah. Yeah.

Yes, it's true. because

I had one, you know, typically we think of zinc levels correlating in our blood, zinc levels in our blood, correlating most closely with animal protein intake. But some people don't eat a lot of animal proteins. Oysters are huge in zinc, but that's not the most kid-friendly food. But, you know, but this one mom who they really didn't, they weren't vegetarian or vegan, but they just didn't eat a lot of animal proteins. And ⁓

taking a zinc supplement wasn't moving the needle on getting her child's zinc level up in her blood. And so what she did was she ground up some pumpkin seeds, you know, in your like coffee bean grinder or food processor, whichever one you want, and just sprinkled it everywhere in her daughter's oatmeal, in baked goods, in salads, in soups. I mean, just snuck it in wherever she could. And it was such a fine powder. It was pretty easy to dissolve.

And within two months her zinc levels had gone up so well I was shocked because I remember checking her blood work and I was like what did you do because she wasn't taking a zinc supplement I'm like, how did you get her zinc levels up? And she said that's that's the only thing she did So, food is really highly absorbable, right? And so the nutrients so ideally we would get what we need from food now if you

Lena Livinsky (22:45)
Wow.

Mm-hmm.

Dr. Elisa Song (22:54)
If you're giving your child a zinc supplement or you're trying to increase zinc rich foods or both and their zinc levels are just not going up, then there might be an issue with absorption. So that's another clear sign that I want to look at your child's gut to see are they actually digesting and absorbing in the way that they should.

Lena Livinsky (23:11)
Yeah. And is there ever a concern for having too much zinc?

Dr. Elisa Song (23:15)
you can get a little too much zinc. zinc toxicity is extremely unlikely, especially at the dosages. know, if you're, for instance, I'm trying to think like so the chewable zincs or the liquid zincs, oftentimes you'll get anywhere from five to 15 milligrams per dose. if you follow the guidelines recommended by age, there's really going to be...

virtually no way to overdo it, right? I mean, you that's where, again, I like to be guided by blood work, but it would be very, very safe to try an over-the-counter zinc supplement. And then if you're not sure, of course, you know, always check with your physician to see is this okay, especially if they're taking any other medications or supplements, but zinc is one of the most common nutrient deficiencies in kids and adults for that matter.

Lena Livinsky (23:37)
Mm-hmm.

Mm-hmm.

Dr. Elisa Song (24:00)
So it's very important to keep on top of.

Lena Livinsky (24:03)
⁓ absolutely. it's so even for picky eaters, I mean, who you might be concerned with giving a supplement to because perhaps they refuse to take it. Like I love the strike of pumpkin seed powder because you can maybe add it to a smoothie, even ice pops. Like if all they eat is ice cream, like you can add it to homemade ice cream. it's very, very doable. let's shift the topic a little bit, there has been a lot of noise lately regarding autism thanks to RFK junior and his claims that

Dr. Elisa Song (24:12)
⁓ Yeah.

That's right.

Lena Livinsky (24:28)
We will know what caused it by September. So do you have a theory here of what could be the cause of autism? And do you believe that children can heal or go into remission with the right treatment?

Dr. Elisa Song (24:39)
Yeah, I mean, a couple of things with that, when it comes to functional medicine, one of the things that I think functional medicine, and I love functional medicine, obviously, that's, a backbone of one of my practices, but I think one of the disservices that functional medicine has really done to patients is to have people think that there is, that there usually is just one root cause. There's rarely,

rarely ever one root cause unless it's a huge poisoning or clearly an infection, right? And then that triggered everything. But for almost all chronic health concerns, it's a cumulative load of environmental exposures kind of matched with your unique genetics, right? That then can flip some switches and produce

Lena Livinsky (25:15)
Hmm.

Dr. Elisa Song (25:35)
health outcomes, poor health outcomes. And many would say, and I know that there is a lot of, in the neurodiverse world, a lot of pushback against the idea that autism is a disease. And so, what I would say is,

Lena Livinsky (25:36)
Mm-hmm.

Dr. Elisa Song (25:53)
However we categorize autism, there are so many behaviors and health concerns that go along with being autistic that as a parent and as a practitioner, a pediatrician, those are what we want to clear. We know that kids on the autism spectrum have a higher risk for seizure disorders, for ⁓ inflammatory bowel disease like Crohn's and ulcerative colitis, for sensory processing issues, for huge behavioral...

concerns like aggression. I'm not just talking, kind of quirky, ⁓ quirky personalities that are functioning amazingly well and thriving, right? But, you know, and there are kids who really don't have any expressive language capabilities. And so, you know, they're not, they're not thriving in this world. And that is what I want to address. And I absolutely think that when we

Lena Livinsky (26:28)
Mm-hmm.

Yes.

Mm-hmm.

Dr. Elisa Song (26:44)
understand some of the underlying biochemical imbalances, the microbiome imbalances, the nutrient deficiencies, mitochondrial concerns that are there, really digging in with targeted testing, we can find answers to really help course correct many of these behaviors and symptoms of autism that are so problematic.

Lena Livinsky (27:07)
Absolutely. and I think it's so important to address as well from this very broad view and not just focus on one diagnosis like you've mentioned, because unfortunately, our kids have so many comorbidities right now. So there's so many things that we can do and another low-hanging fruit kind of entry point that we can find to start addressing these concerns, because even though we want to support

this neurodiverse ⁓ personality that a lot of these kids show and this beautiful, special way of being. However, a lot of them, only eat beige foods. And we know that can, over time, cause a lot of health issues in itself. So it's just a lot of things to think about here as well. the CDC also released new data showing that one in three teenagers now has pre-diabetes.

Dr. Elisa Song (27:47)
Yeah. Yeah, for sure.

Yeah.

Lena Livinsky (27:55)
And that number is staggering and yet another reflection of our health crisis that we're in right now. So from your perspective, what are some realistic impactful steps families families can take to support better health for their kids?

Dr. Elisa Song (28:08)
Yeah. And I want to point out to families and to kids, parents and kids that, the one in three kids who are now diagnosed with pre-diabetes, they are not necessarily the kids that we think of as getting diabetes. They're not necessarily obese and sedentary and, inactive, right? I have, kids in my practice who are athletes. They look very slim and they look fit.

And yet when I check their fasting blood work, they have all the signs of pre-diabetes with high insulin, fasting insulin and high hemoglobin A1c. And it is startling. And I would say this one in three number that the CDC is quoting, these are kids who already have elevated hemoglobin A1c's. What I am seeing is this kind of even this pre,pre-diabetes, which is this.

Lena Livinsky (28:38)
No.

Mm-hmm.

Dr. Elisa Song (28:59)
high fasting insulin, hemoglobin A1c still looks normal, but their blood sugar regulation is not normal. And this is really important. And you know, the biggest culprit for our kids is their sugar intake. I mean, sugar is so sneaky. of course, know, lot of parents, parents listening to this, they know, okay, I shouldn't give my kids candy and too many cakes and too many. I'm talking about sugar hiding in plain sight.

you know, in our salad dressings and, in protein bars and, in foods, in bread, in, you know, gluten-free whole grain bread. I mean, these foods that we think we're making healthier swaps, but then in the end, when we look at the added sugar content, we're loading our kids and ourselves with sugar without even knowing it, right?

a cookie or an ice cream that's that's a known thing. But what I want and what I teach kids and parents to do is really read every single food label, like a gut hero, look at the added sugar content, and really keep in mind that children two to 18 years of age should have no more than 25 grams of added sugar in a day, which equates to about six teaspoons. Okay, so

Lena Livinsky (30:12)
Mm-hmm.

Dr. Elisa Song (30:13)
I tell my kids, teens now, and so they know, okay, 25 grams or six teaspoons, when they look at a label, like let's say they go to boba tea with their friends and they wanna get a boba, the lowest sugar boba is still going to be something like 35 grams of added sugar in a day. That's about nine teaspoons.

So they're already over their daily allotment and that doesn't include what's in there, maybe in their smoked ham deli slices and their sandwich bread organic jam. I all these things, it just all adds up. so for me, I completely understand it is not realistic.

Lena Livinsky (30:45)
Right.

Dr. Elisa Song (30:56)
as a parent to say, don't ever have any of these. Because how many parents walk around with a Starbucks Frappuccino? And how many parents love bowl of ice cream here and there? It's just that we're doing it too often. And what I'm seeing with kids is a sneaky, sneaky increase where they start having maybe one Starbucks drink with their friends once a week. And then as they get older,

Lena Livinsky (31:02)
Right.

Mm-hmm.

Dr. Elisa Song (31:20)
after school, they're all walking downtown together. And then all of a sudden it becomes a daily thing. But I just, I literally just saw this with one young woman. she's 15. I mean, my daughter's 15. and she's plays volleyball, she's athletic, she's slim. And I was floored to see her fasting insulin at very high levels, higher than normal.

I mean, I still, I look to see, they kind of bumping up, you know, getting on the higher end of normal? She was outright abnormal, right? And we will meet and have a discussion and just kind of go through where is this sugar sneaking in? It's really, it's through no fault of our own because the food manufacturers don't want us to realize that, just trying to think.

Lena Livinsky (31:44)
Mm-hmm.

Yeah.

Dr. Elisa Song (32:05)
of what things are like the spaghetti sauce that we're having has added sugar or all these things. If we're not looking at the label, we're not thinking sugar, right? We do think sugar when it comes to candy and cakes and cookies, but we're not thinking sugar when it comes to salad dressing or other condiments or even protein bars. I always have kids look at protein bars because a lot of middle schoolers and high schoolers are like, I'll just have a protein bar as a snack, right?

Lena Livinsky (32:14)
Yes.

Mm.

Mm-hmm.

Dr. Elisa Song (32:34)
But some of them are just junk with either too much added sugar or what I would say even worse is the artificial sweeteners. I mean, those are not any better. It is not the solution to go to sucralose or acetyl sulfate, potassium or saccharin. The solution is just to lower our sugar intake so that our taste buds don't want as much sugar.

Lena Livinsky (32:55)
And what do you think about Stevia and Monk Fruit, which are often used in these health brands and health conscious brands? And I feel like they're being added into a lot of these things as a substitute for sugar. What do you think about that?

Dr. Elisa Song (33:10)
Yeah, I think they can be okay in moderation. There's actually some evidence that monk fruit may have some benefits for the gut microbiome, but they are much sweeter than sugar. as the sugar replacement, they don't necessarily raise our blood sugar.

Lena Livinsky (33:22)
Mm-hmm.

Dr. Elisa Song (33:28)
but they don't change our desire for sweet. So that's a fallacy, right? I think when they were first coming out with these artificial sweeteners and sugar substitutes, the thought was, well, this is gonna reduce our risk for diabetes because it's gonna reduce our intake of sweets. And it doesn't necessarily, it has not been shown to reduce risks of diabetes later on in life. I just, I think overall just really,

Lena Livinsky (33:49)
⁓ Okay.

Dr. Elisa Song (33:53)
getting back to the sweetness of real foods, you fruit in so many cultures is dessert, right? And so really training our taste buds and our bodies to just not want as much sugar. That is the real key in getting this diabetes epidemic under control.

Lena Livinsky (33:59)
Mm-hmm.

I agree. And even talking about picky eaters, if you do have kids who just love to snack and this is their main calories for the day, there's things that you can swap at home. Maybe instead of giving them chocolate chip cookies, you bake them at home and you put less sugar in there and then slowly do less and less and less until they get used to this different type of flavor profile. But there's a lot of things you can do even in that case.

Dr. Elisa Song (34:25)
That's right.

Yeah. And it is, you know, for infants and babies. So babies under two should have zero grams of added sugar. Right. But it's sneaking in. In fact, I was really alarmed when I saw this, you know, this ad for this, organic Stonyfield Yo Baby yogurt ⁓ in different strawberry flavors, blueberry flavors, whatever it is. And it says number one pediatrician recommended baby yogurt. Right. So

Lena Livinsky (34:51)
Yes.

Dr. Elisa Song (35:00)
And, know, before I really was aware of the microbiome and sugars, I don't think I would have looked at the label. But I looked at the label and that canister of baby yogurt had almost a teaspoon per serving. Like your baby should have no grams of added sugar. So what's the solution? Buy whole milk, plain Greek yogurt.

Lena Livinsky (35:10)
Yeah.

Mm-mm.

Dr. Elisa Song (35:25)
And just add some real strawberry puree or real blueberry puree. They don't need the added sugars.

Lena Livinsky (35:31)
Yes. that's exactly what I did, because the same brand, I picked it up one day in the store when I was shopping for my son, Nate, and I was just floored. I was like, oh my goodness, it's hiding everywhere. It's a big issue. So in your book, you discuss a concept you call whole child resilience. What do you mean by that?

Dr. Elisa Song (35:40)
Yeah, yeah.

So one of the things that we as parents are, it's just as moms, it's just, know, innate to us that we want to keep our kids safe and happy, right? But that often means in the end that we are kind of bubble wrapping our kids and shielding them, from upset, frustration and all the things that really

do create growth and mindset resilience in our kids. So many adults have heard of resilience in the terms of, okay, the gift of failure, let your kids fail and bounce back from it. But we have to apply that same thing to them from a physical and immune system standpoint. Because the same thing, like mentally we learn with every knock back we overcome,

and we gain more confidence for the next time. Well, even with getting sick or exposed to, I'll say sick first because it's mostly like viruses and colds, right? Where, you know, parents are the hand sanitizer and, don't touch anything. I don't want my kids ever to get sick. However, every time your child gets sick, it trains their immune system. And then I always recommend more integrative tools like herbs and essential oils to help your kids recover faster.

And then every time they recover completely, their immune system actually retains that memory and learns how to do it better the next time. So this is the idea of building resilience. It's not about shielding your kids from everything. It's about laying the foundations so that whatever they can they can overcome it quickly and completely and be stronger for the next time.

Lena Livinsky (37:32)
Absolutely. That makes me think of back in the day when I was growing up in Poland, I spend the whole day outside, play in the dirt, do everything. And I feel like we're shielding our kids from that. I mean, the environment is very different now, but in terms of like just getting dirty, I feel like it's no longer a thing, right? It's a lot of it is just like, let me get my hand sanitizer out. Let's clear your hands. it's a, yeah. I think we overdo it a little bit as well.

Dr. Elisa Song (37:48)
Yeah.

Yeah.

Well, enhanced sanitizer has been shown to disrupt your gut microbiome, right? ⁓ And just being too clean. I mean, we know that that is conjectured to be part of what's called the hygiene hypothesis where we've just become too clean and too sanitary and we actually need exposure to the microbes around us.

Lena Livinsky (38:01)
Mmm, not surprised.

Dr. Elisa Song (38:18)
to train our gut microbiome and train our immune system. And so if we don't give our kids that opportunity when they're little, it doesn't train their immune systems and may even increase the risk then of things like eczema and asthma and allergies, which are also very high in kids.

Lena Livinsky (38:36)
I really believe there's so much wisdom in the way previous generations cared for health, like our grandmothers and great grandmothers. So what's one piece of health or wellness wisdom from past generations that, from your family, that you're intentionally preserving and passing down to your kids?

Dr. Elisa Song (38:49)
Wow. I mean, I think that for me, you know, even in the busyness of our schedules and for now, my kids are in high school. so, I mean, sometimes their sports practices are 7 to 8.30 and family meals during the week are just not happening that much. Right. But it's for me, one thing that was very important to instill in my kids is ⁓ the

Lena Livinsky (39:07)
Mm-hmm.

Dr. Elisa Song (39:15)
the skill set and also the enjoyment of cooking. I think that if we, there's so many benefits to learning how to cook and then having at least one family meal a week. I mean, even for me, my mom was a busy OB-GYN, her office was attached to her house. I mean, sometimes she would work until nine o'clock seeing patients, but she always carved out time at dinnertime.

Lena Livinsky (39:26)
Mm-hmm.

Dr. Elisa Song (39:40)
where she had no patients and she came in and had dinner with us. And then she would go back and see patients. So for me, having family dinner time as often as we can is very important. We're sitting there, no screens, we're chit chatting, we're catching up on the day, or maybe just running through whatever the happenings are. Oftentimes that's our time to kind of regroup and look at the schedule for the next day, right? And then cooking.

I still, mean, some of my best memories growing up was sitting in my living room with the screen door wide open, looking at our backyard and just, you know, making like sheets and sheets of Korean pot stickers, which are called mandu, right? ⁓ And then just end like folding them and just sitting there. sometimes we would be, you know, just even sometimes in silence. And sometimes we would chat, but ⁓ there was just something so peaceful about that. And you have your hands in the food, you're making it.

Lena Livinsky (40:08)
Yeah.

Mmm. that sounds so good. ⁓

Yeah.

Mm-hmm.

Dr. Elisa Song (40:36)
You know, it's just, you know exactly what the ingredients are. And, you know, it it's so much, it tastes just so much better when you can make it with that intention.

Lena Livinsky (40:40)
Yeah.

Yeah.

Absolutely. that's, that's beautiful. And, and it's such an important skill, not only for our health, but I think for our nervous system and our microbiome and everything else. And it's, it's so basic, right? Because you don't need to know how to cook a hundred things. You can learn how to cook five things that are going to make a difference in your life. so this is the question I like to ask everyone at the end of my interview. So if you could share just one piece of advice with parents who want to raise healthier, more resilient kids in this world, what would it be?

Dr. Elisa Song (40:59)
Yep. Yeah. Yeah.

You know, every time I think about this question, it's a different, it probably shifts depending on what's been going on, you know, in my life and the world around me. But I would say, right now, the biggest piece of advice would be, you know, just to move forward and it's progress over perfection. Like that is really the key, right? I mean, there so many things we could be doing, but we don't need to do all of them right now, right? So you just pick one thing.

move forward, then you pick the next. When you start really on this holistic health journey, it can feel very overwhelming. Like, my gosh, I have to clear all of the cleaners under my cabinet. I have to change all of our body and hair care products. I have to change all of the food. We have to change our bedtime routine. I mean, all of the things. And it can feel really overwhelming. And so it's just take it one day at a time, one step at a time.

and expect that you're going to make some mistakes and that those mistakes are going to be learning opportunities. Because as we go forward and we make these mistakes and then we move forward, our kids see us doing that too. So we just keep going one day at a time.

Lena Livinsky (42:20)
Yeah, that's beautiful. There's power in that because that sets up that domino effect of other things coming into place and things shifting in the right direction. So what are some ways parents can work with you? Are you accepting any new patrons? Are you maybe launching a parents-based membership?

Dr. Elisa Song (42:35)
I'm not, unfortunately, taking new patients right now, which is why I have a Healthy Kids, Happy Kids practitioner membership, because I would love to have a huge community of integrative pediatric practitioners to care for kids across the country, across the world. And then I also am soon launching a Healthy Kids, Happy Kids

parent membership where they can listen to master classes taught by me and special guests on different holistic integrated pediatric topics, resources, live Q &As, my ⁓ AI clone to ask me questions any time of day. So I'm really excited for that. It's a resource that I think...

will be a value for so many families, especially who don't have a holistic pediatrician near them and can just, and also a community. That's probably the most important aspect of it because a lot of us can feel alone on this journey. know, not a lot of family members or friends who may be like-minded or, you

Lena Livinsky (43:22)
I

Dr. Elisa Song (43:39)
other parents at our kids' And so, you know, this having a community, which is not Facebook, it's housed in ⁓ Mighty Networks. So a safe, secure community where parents can get together and connect and really support each other.

Lena Livinsky (43:41)
Mm-hmm

I've been in the practitioner membership from the beginning and there's so much value in there in terms of how much you learn even from just one lecture. So I can't recommend it enough. I know it's going to be fabulous. ⁓ Do you know when it's launching yet? Okay, soon. Okay. So anybody interested? Definitely. If you can't sign up, it's worth it.

Dr. Elisa Song (44:06)
Thank you. Thank you.

It's launching in August. Very soon.

Lena Livinsky (44:16)
⁓ Well, Dr. Song, thank you so much for coming on. It was such a great conversation. I learned a ton and I hope everybody listening did as well. And if anybody wanted to follow you online, where could they find you?

Dr. Elisa Song (44:28)
So the best place is my website, healthykidshappykids.com and also on Instagram, which is healthykids underscore happykids.

Lena Livinsky (44:37)
Okay, perfect. Well, thank you for coming on.

Dr. Elisa Song (44:39)
Thanks for having me.